Review of Ghana’s food environment: Drivers of availability, barriers to healthy food access, and impact of interventions and policies

Food environments exert a significant effect on population dietary choices and health outcomes. Policies that influence the food environment, can have a significant impact on individual and population dietary choices. This rapid review assessed the nature and interaction within the Ghanaian food environment, and the impact that existing school, workplace, and national food policies have on dietary intake and nutritional outcomes. Online databases and university repositories were searched for relevant articles and documents. A total of forty articles and documents were included in the review. Majority of the reviewed papers (85%) used a cross-sectional design. The findings show that traditional outlets (open markets) constitute the main food source among the Ghanaian populace, while convenience stores serve as an important source of processed foods. Prepared local foods are often consumed outside the home and are mainly sourced from street food vendors. Street foods are perceived as less expensive, convenient, and delicious. The food environment was found to influence dietary acquisition, intake, and nutritional outcomes. Although most nutrients provided by the School Feeding Programme (SFP) are below recommended intake standards, the SFP contributes positively to improved diets and nutrition status of school-age children. Children attending SFP-implementing schools experience higher intakes of protein, iron, zinc, calcium, vitamin A, folate, and have higher haemoglobin, and lower prevalence of stunting, underweight, and thinness than children in non-SFP implementing schools. Availability of a private room for breastfeeding mothers improved breastfeeding frequency. Ghana’s fatty meat restriction policy has reduced the availability and sale of fatty meat on the Ghanaian market. Reported drivers and barriers to healthy foods consumption include socio-economic factors, media information, food storage facilities, cultural perception, fruit seasonality, knowledge on the nutrient value of fruits and vegetables, safety profile of fruits and vegetables, and contribution of household production to dietary intake. In conclusion, the food environment review reveals the drivers of availability, barriers to healthy food access, and impact of interventions and policies on the Ghanaian food environment.&nbsp

Dietary patterns and nutrient intakes of a South African population and asymptomatic people infected with Human Immunodeficiency Virus: The transition health and urbanisation in South Africa (Thusa) study

There is increased emphasis on the quality of food and the overall pattern of micronutrient intake as an integral consideration for food security particularly among people living with HIV/AIDS (PLWHA). However, limited data exist on food consumption and nutrient intakes for populations in sub-Saharan Africa. The study examined dietary patterns and their relationship with nutrient intakes in HIV uninfected (HIV-) and infected (HIV+) adults in North-West Province, South Africa. In this cross-sectional study, dietary and nutrient intakes were assessed with Quantitative Food Frequency Questionnaire (QFFQ) and FoodFinder software, respectively. Dietary patterns were determined using Principal Component Analysis. Participants’ scores for the dietary patterns were related to nutrient intakes using Spearman Rank correlation and Generalised Linear Modelling (GENLIN). Four main dietary patterns were found in each population. The first three patterns were similar between the HIV- and HIV+ populations: “animal-based”, associated with intake of foods of animal origin; “recommended” associated with a varied diet; and “staple-based”. The fourth pattern was described as either ‘eggs-and-breakfast-cereals’ for the HIV- group or ‘legumes-and-vegetables’ for HIV+ group. Scores for animal-based pattern showed strongest correlations (r) with nutrient intakes for both populations, notably zinc (r=0.54), calcium (r=0.5), potassium (r=0.54), vitamin A (r=0.5), and vitamin C (r=0.5), (p<0.001 for all). In the HIV+ group, the legumes-and-vegetables pattern was strongly associated with energy (r=0.64), vitamins D (r=0.51), E (0.51) and B1 (r=0.55) (p<0.001 for all). Compared with the other patterns, the Staple-based and the recommended patterns showed the weakest associations with nutrient intakes. Generalised Linear Modelling confirmed stronger positive linear associations between scores of the animal-based diet and nutrients intake, compared with the other patterns. The findings suggest that the animal-based pattern was strongly associated with nutrients intake in both HIV + and HIV- populations. This raises the need for studies into dietary recommendations for promoting nutritional wellbeing for PLWHA in sub-Saharan Africa.Keywords: Dietary patterns; HIV/AIDS; THUSA, Nutrient

A review of Ghana’s food system and its implications on sustainability and the development of national food-based dietary guidelines

Food-Based Dietary Guidelines (FBDG) provide culturally-appropriate and actionable recommendations based on which populations can make healthy food choices. Food systems sustainability, from production to consumption, and disposal of food and foodrelated items, should be a critical consideration for developing such guidelines. This rapid review assesses Ghana's food systems to determine the level of sustainability to inform the FBDG recommendations. Peer-reviewed articles, documents and reports of relevance to Ghana were included in this rapid review. A hundred and eight papers, answering different questions on food system sustainability were reviewed. Bread, cereals, fish and indigenous vegetables are the most frequently consumed food groups. Sugar-Sweetened Beverages are the most consumed imported foods. In rural areas, 53% of dietary protein comes from plant sources. Fish is the main the source of animal protein for most Ghanaian households. There is intensive exploitation of marine and fresh water resources. Most livestock are raised by smallholder farmers using freerange system. Poultry is frequently kept on deep litter system and only a few are largescale. Crop production for household consumption and small-scale animal rearing are predominant, especially in Northern Ghana. By weight, fruits and vegetables are the least cultivated and consumed crops at the household level. Wood is the commonest source of fuel for cooking, especially in rural areas. Single use plastic is the most used and preferred material for food packaging. Indiscriminate and poor management of waste and pesticide misuse is commonly reported. The findings suggest the need for promoting production diversification, use of clean fuel and reusable food packaging as part of FBDGs to enhance sustainability of Ghana’s food systems

A review of Ghana’s food system and its implications on sustainability and the development of national food-based dietary guidelines

Food-Based Dietary Guidelines (FBDG) provide culturally-appropriate and actionable recommendations based on which populations can make healthy food choices. Food systems sustainability, from production to consumption, and disposal of food and foodrelated items, should be a critical consideration for developing such guidelines. This rapid review assesses Ghana's food systems to determine the level of sustainability to inform the FBDG recommendations. Peer-reviewed articles, documents and reports of relevance to Ghana were included in this rapid review. A hundred and eight papers, answering different questions on food system sustainability were reviewed. Bread, cereals, fish and indigenous vegetables are the most frequently consumed food groups. Sugar-Sweetened Beverages are the most consumed imported foods. In rural areas, 53% of dietary protein comes from plant sources. Fish is the main the source of animal protein for most Ghanaian households. There is intensive exploitation of marine and fresh water resources. Most livestock are raised by smallholder farmers using freerange system. Poultry is frequently kept on deep litter system and only a few are largescale. Crop production for household consumption and small-scale animal rearing are predominant, especially in Northern Ghana. By weight, fruits and vegetables are the least cultivated and consumed crops at the household level. Wood is the commonest source of fuel for cooking, especially in rural areas. Single use plastic is the most used and preferred material for food packaging. Indiscriminate and poor management of waste and pesticide misuse is commonly reported. The findings suggest the need for promoting production diversification, use of clean fuel and reusable food packaging as part of FBDGs to enhance sustainability of Ghana’s food systems.&nbsp

Evaluation of sexual history-based screening of anatomic sites for chlamydia trachomatis and neisseria gonorrhoeae infection in men having sex with men in routine practice

<p>Abstract</p> <p>Background</p> <p>Sexually transmitted infection (STI) screening programmes are implemented in many countries to decrease burden of STI and to improve sexual health. Screening for <it>Chlamydia trachomatis </it>and <it>Neisseria gonorrhoeae </it>has a prominent role in these protocols. Most of the screening programmes concerning men having sex with men (MSM) are based on opportunistic urethral testing. In The Netherlands, a history-based approach is used. The aim of this study is to evaluate the protocol of screening anatomic sites for <it>C. trachomatis </it>and <it>N. gonorrhoeae </it>infection based on sexual history in MSM in routine practice in The Netherlands.</p> <p>Methods</p> <p>All MSM visiting the clinic for STI in The Hague are routinely asked about their sexual practice during consulting. As per protocol, tests for urogenital, oropharyngeal and anorectal infection are obtained based on reported site(s) of sexual contact. All consultations are entered into a database as part of the national STI monitoring system. Data of an 18 months period were retrieved from this database and analysed.</p> <p>Results</p> <p>A total of 1455 consultations in MSM were registered during the study period. The prevalence of <it>C. trachomatis </it>and <it>N. gonorrhoeae </it>per anatomic site was: urethral infection 4.0% respectively and 2.8%, oropharynx 1.5% and 4.2%, and anorectum 8.2% and 6.0%. The majority of chlamydia cases (72%) involved a single anatomic site, which was especially manifest for anorectal infections (79%), while 42% of gonorrhoea cases were single site. Twenty-six percent of MSM with anorectal chlamydia and 17% with anorectal gonorrhoea reported symptoms of proctitis; none of the oropharyngeal infections were symptomatic. Most cases of anorectal infection (83%) and oropharyngeal infection (100%) would have remained undiagnosed with a symptom-based protocol.</p> <p>Conclusions</p> <p>The current strategy of sexual-history based screening of multiple anatomic sites for chlamydia and gonorrhoea in MSM is a useful and valid guideline which is to be preferred over a symptom-based screening protocol.</p

Henipavirus RNA in African Bats

BACKGROUND: Henipaviruses (Hendra and Nipah virus) are highly pathogenic members of the family Paramyxoviridae. Fruit-eating bats of the Pteropus genus have been suggested as their natural reservoir. Human Henipavirus infections have been reported in a region extending from Australia via Malaysia into Bangladesh, compatible with the geographic range of Pteropus. These bats do not occur in continental Africa, but a whole range of other fruit bats is encountered. One of the most abundant is Eidolon helvum, the African Straw-coloured fruit bat. METHODOLOGY/PRINCIPAL FINDINGS: Feces from E. helvum roosting in an urban setting in Kumasi/Ghana were tested for Henipavirus RNA. Sequences of three novel viruses in phylogenetic relationship to known Henipaviruses were detected. Virus RNA concentrations in feces were low. CONCLUSIONS/SIGNIFICANCE: The finding of novel putative Henipaviruses outside Australia and Asia contributes a significant extension of the region of potential endemicity of one of the most pathogenic virus genera known in humans

Modular Mass Spectrometric Tool for Analysis of Composition and Phosphorylation of Protein Complexes

The combination of high accuracy, sensitivity and speed of single and multiple-stage mass spectrometric analyses enables the collection of comprehensive sets of data containing detailed information about complex biological samples. To achieve these properties, we combined two high-performance matrix-assisted laser desorption ionization mass analyzers in one modular mass spectrometric tool, and applied this tool for dissecting the composition and post-translational modifications of protein complexes. As an example of this approach, we here present studies of the Saccharomyces cerevisiae anaphase-promoting complexes (APC) and elucidation of phosphorylation sites on its components. In general, the modular concept we describe could be useful for assembling mass spectrometers operating with both matrix-assisted laser desorption ionization (MALDI) and electrospray ionization (ESI) ion sources into powerful mass spectrometric tools for the comprehensive analysis of complex biological samples

Respiratory viruses in children hospitalized for acute lower respiratory tract infection in Ghana

<p>Abstract</p> <p>Background</p> <p>Acute respiratory tract infections are one of the major causes of morbidity and mortality among young children in developing countries. Information on the viral aetiology of acute respiratory infections in developing countries is very limited. The study was done to identify viruses associated with acute lower respiratory tract infection among children less than 5 years.</p> <p>Method</p> <p>Nasopharyngeal samples and blood cultures were collected from children less than 5 years who have been hospitalized for acute lower respiratory tract infection. Viruses and bacteria were identified using Reverse Transcriptase Real-Time Polymerase Chain Reaction and conventional biochemical techniques.</p> <p>Results</p> <p>Out of 128 patients recruited, 33(25.88%%, 95%CI: 18.5% to 34.2%) were positive for one or more viruses. Respiratory Syncytial Virus (RSV) was detected in 18(14.1%, 95%CI: 8.5% to 21.3%) patients followed by Adenoviruses (AdV) in 13(10.2%, 95%CI: 5.5% to 16.7%), Parainfluenza (PIV type: 1, 2, 3) in 4(3.1%, 95%CI: 0.9% to 7.8%) and influenza B viruses in 1(0.8%, 95%CI: 0.0 to 4.3). Concomitant viral and bacterial co-infection occurred in two patients. There were no detectable significant differences in the clinical signs, symptoms and severity for the various pathogens isolated. A total of 61.1% (22/36) of positive viruses were detected during the rainy season and Respiratory Syncytial Virus was the most predominant.</p> <p>Conclusion</p> <p>The study has demonstrated an important burden of respiratory viruses as major causes of childhood acute respiratory infection in a tertiary health institution in Ghana. The data addresses a need for more studies on viral associated respiratory tract infection.</p

Do salivary bypass tubes lower the incidence of pharyngocutaneous fistula following total laryngectomy? A retrospective analysis of predictive factors using multivariate analysis

Salivary bypass tubes (SBT) are increasingly used to prevent pharyngocutaneous fistula (PCF) following laryngectomy and pharyngolaryngectomy. There is minimal evidence as to their efficacy and literature is limited. The aim of the study was to determine if SBT prevent PCF. The study was a multicentre retrospective case control series (level of evidence 3b). Patients who underwent laryngectomy or pharyngolaryngectomy for cancer or following cancer treatment between 2011 and 2014 were included in the study. The primary outcome was development of a PCF. Other variables recorded were age, sex, prior radiotherapy or chemoradiotherapy, prior tracheostomy, type of procedure, concurrent neck dissection, use of flap reconstruction, use of prophylactic antibiotics, the suture material used for the anastomosis, tumour T stage, histological margins, day one post-operative haemoglobin and whether a salivary bypass tube was used. Univariate and multivariate analysis were performed. A total of 199 patients were included and 24 received salivary bypass tubes. Fistula rates were 8.3% in the SBT group (2/24) and 24.6% in the control group (43/175). This was not statistically significant on univariate (p value 0.115) or multivariate analysis (p value 0.076). In addition, no other co-variables were found to be significant. No group has proven a benefit of salivary bypass tubes on multivariate analysis. The study was limited by a small case group, variations in tube duration and subjects given a tube may have been identified as high risk of fistula. Further prospective studies are warranted prior to recommendation of salivary bypass tubes following laryngectomy